Billing code 54250: Nocturnal erection testingMedicare rate & RVUs

Medicare pays $123.58 for 54250 nationally in the office. Local office rates run $113.92–$159.39.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 54250 covers

This test monitors changes in penile size and rigidity during sleep, typically overnight, as part of an evaluation for erectile dysfunction. A urology practice may arrange the study, with staff applying or setting up monitoring equipment and a qualified clinician interpreting the recorded results. The findings can help assess whether normal sleep-related erections occur; they are considered alongside the patient’s history and other evaluation findings.

Report the study when nocturnal tumescence and rigidity are measured and interpreted, rather than for penile plethysmography or an invasive vascular study. Documentation should identify the erectile dysfunction evaluation, describe the study performed, and include the recorded findings and interpretation. Modifier 26 identifies the professional interpretation, TC identifies the technical service, and an unmodified claim represents the global service. The 0-day global includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 54250 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

54250 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 54250 rate is calculated

Each of 54250’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 54250

The CMS indicators that decide how 54250 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

54250 compared with similar codes

How to choose

54240Penile plethysmography

Choose 54250 for overnight recording of penile tumescence and rigidity during sleep. Code 54240 describes penile plethysmography, a separate testing method.

54230Cavernosography

Code 54230 is for cavernosography, an invasive imaging assessment of penile vascular anatomy; it does not report nocturnal monitoring.

54231Cavernosometry

Code 54231 reports dynamic cavernosometry, an invasive vascular assessment. Code 54250 measures tumescence and rigidity during sleep.

Codes related to 54250

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates